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Risks associated with blood transfusion after total knee arthroplasty
Matthew R Bong1, Vipul Patel, Eric Chang
1NYU-Hospital for Joint Diseases, Department of Orthopaedic Surgery, New York, New York, USA.
The Journal of Arthroplasty
|April 7, 2004
Summary
Pre-donating autologous blood before total knee arthroplasty (TKA) significantly reduces the need for allogeneic transfusions. Patients with higher preoperative hemoglobin or younger than 65 may not benefit from this practice.
Area of Science:
- Orthopedic Surgery
- Transfusion Medicine
Background:
- Total knee arthroplasty (TKA) is a common procedure associated with potential blood loss.
- Allogeneic blood transfusions carry inherent risks and resource implications.
Purpose of the Study:
- To evaluate the effectiveness of autologous blood pre-donation in reducing allogeneic transfusions after primary TKA.
- To identify patient subgroups who may not benefit from autologous blood pre-donation.
Main Methods:
- Retrospective study of 1,402 patients undergoing primary TKA.
- Analysis of predictors for allogeneic transfusion, including age, preoperative hemoglobin, and postoperative medication.
- Comparison of transfusion rates with different units of pre-donated autologous blood.
Main Results:
- Advancing age, low preoperative hemoglobin, and postoperative low-molecular-weight heparin were significant predictors of allogeneic transfusion.
- Pre-donating 1 unit of autologous blood reduced the allogeneic transfusion rate from 38% to 11%.
- Pre-donating 2 units further decreased the allogeneic transfusion rate to 7%.
Conclusions:
- Autologous blood pre-donation is effective in minimizing allogeneic transfusions following TKA.
- Patients with preoperative hemoglobin >150 g/L, or those younger than 65 with hemoglobin >130 g/L, may not benefit from pre-donation, potentially leading to blood wastage.